SherriJones

Phrases used wherever I've worked Brain = report sheet where you took notes at shift change and plotted out your day Christmas tree = green O2 adapter Code Brown = incontinent bowel movement overwhelming in either amount, odor, or runniness Du'av kees = "Do you have [the narcotic] keys?" run together, sounds like you're speaking Indian or Pakistani Frequent Flyer = patient whose frequency of returning to our care unit far, far surpasses that of every other patient GI cocktail = M.O.M., belladonna, and lidocaine concoction Hat = urine collector that can be set inside the toilet Red Robin = the in and out urinary cath kit with the customary red catheter SCDs or Scuds = Sequential Compression Device or leg massagers Slug = postop patient who consistently refuses to get out of bed or ambulate Stopcock = three way valve for IV Vitamin A = Ativan, Vitamin H = Haldol My own additions I regularly use Armani designer fashion = hospital gown, tread socks, and whatever else the doctor ordered, like TED hose B.S.C. = a mental health condition manifesting in an ER Psych patient which stands for Bat Sh*t Crazy "If Mary Kay was here do you know what she'd ask you? 'Would you like a little blush for those cheeks?'" = Dear patient, your backside is exposed. Let me tie your gown." "Those little pancake thingies," "EKG buttons" = electrodes Darnitall = Donnatal "Oh GOODIE! Yeah, yeah yeah!" = patient has a shockingly deep or bloody wound I also worked on a unit where "Bacon Thirty" was the time the dining hall could start selling breakfast to staff, and another hospital where premie babies were "frogs"

In the Air Force, where we have lots of fit, handsome soldiers as patients, it was customary for PACU to give us med-surg nurses report and include the code words "E.O.E." or "E.C." E.O.E. was a 9 and E.C. was a 10, if you get my drift. (Easy on the Eyes, and Eye Candy, respectively).

I believe the category my last ER unit jokingly told me I was in, was "Sh*t Magnet." Pardon the implied swear word, but that always cracked me up and let me know they understood.

Welcome to Canada!

Another nurse once pointed out to me that there is such a thing as the difference between a nurse-run hospital and a doctor-run hospital. Nurse-run hospitals do better. The nurses are happier, empowered, and the patients do better. There are fewer errors and fewer problems. The opposite is true where the doctors are allowed to run the hospital as they see fit. The nurses are treated like hand maidens, receive little support, if any, are more stressed, and there are more errors, etc. I can always tell which kind I'm working in. The clinic where the doctors were spoiled and had to have things a certain way, every time, with zero patience for variation, and the fact that you were new and still learning was inexcusable. I lasted a month. The ER I'm in now, the doctors call the lab themselves to follow up on a pending test that should be "back by now." The lab comes and draws for us, no complaint, no question, or they'll stand by for pick up while you start the IV and take the specimen to the lab for you. If you're busy, most of the time they remember to find you and ask if they should go ahead and draw or should they wait for the IV start. Housekeeping is usually on it as soon as a patient is discharged. If I have time, I will usually strip the bed for them, throw away any trash and dispose of bio-hazards. I don't mind wiping the bed down if we can keep the wait time down in the waiting room. I thank housekeeping and the CNA whenever I can for whatever I can so they can feel appreciated, lifted. So it peeves me a little bit when I see signs that other disciplines act like they run the hospital. The pharmacy tech who won't deliver the med and insist you come pick it up, no matter how busy you are. The IV certified contrast CT tech who rolls their eyes when the patient's IV is not in the AC, despite the blatantly white gauze pressure dressing taped to each antecubital vein access point, indicating you already tried there, twice. Or the housekeeper who thinks their job ought to include just mop and trash who complains nursing doesn't clean the room enough before they get there.

Patients and family can't really leave a cash tip, but as a general rule, anything that starts with a "C" is a great appreciation gift for your nurse. Cake, especially cheesecake Candy, especially CHOCOLATE Champagne COFFEE, or even coffee creamer Hand cream or even Cara oranges Fresh cherries

This poem, mounted as a decent size poster right above the desk where I studied each night, kept me going, kept me from quitting the program, and got me through all four years no matter what happened in school or life, or in the past: [h=3]When things go wrong, as they sometimes will, When the road you're trudging seems all uphill,When the funds are low and the debts are high,And you want to smile, but you have to sigh,When care is pressing you down a bit-Rest if you must, but don't you quit. Life is queer with its twists and turns, As every one of us sometimes learns,And many a fellow turns aboutWhen he might have won had he stuck it out.Don't give up though the pace seems slow -You may succeed with another blow. Often the goal is nearer than It seems to a faint and faltering man;Often the struggler has given upWhe he might have captured the victor's cup;And he learned too late when the night came down,How close he was to the golden crown. Success is failure turned inside out - The silver tint in the clouds of doubt,And you never can tell how close you are,It might be near when it seems afar;So stick to the fight when you're hardest hit -It's when things seem worst that you must not quit.[/h]

The United States Air Force used to teach a certain nursing fundamental to its nurses; that even if you were lower ranking, if someone of higher rank was making your job harder or impossible, it was expected of you to take back control for the good of the patient. I loved that. It gave me permission to order four star Pentagon generals to take their heart medications, in the way doctors to give the nurse back their chair, computer, etc., and permission to lean down to a "slug" and whisper my cuss word rich lecture into their ear (our slang for patients who refuse to walk or get out of bed after surgery). It went something like this, "Before I start in on you, I want you to know I am a Christian woman, the utmost nursing professional, and normally don't swear at my patients, but the other nurses are referring to you as a slug. It is my duty as a nurse to lean down in your ear and tell you to get out the **** out of bed, and WALK, NOW, before you ******* die of pneumonia." Then I would stand up, point at my red hair, and say, "Mother Nature uses bright colors to warn others of a dangerous animal. Venomous, poisonous, etc. As a red headed nurse I thought it my duty to remind you that you might not want to **** me off." Then I would top it off with, "You are NOT going to say no to me. Get the **** out of bed." The way I did it, professional but firm, and ready to back up any question or objection with solid medical science, they would always be amused, oblige me, walk, and within 48 hours would be thanking me for making them get moving, that they finally had less pain, felt better than ever, etc. It is in this spirit I have no problem telling a patient that the delay in their care was due to a fresh EMS patient, or some critical change in another patient requiring rapid response. I remind them that if they were that patient who was having the real emergency, that they would appreciate the other patients being understanding and for waiting. Works every time. Patients really do understand and appreciate a nurse with professional control. It represents humanity, it reflects on us doing our best, and in my opinion, it is a key in preventing burn out. Do everything you can to KEEP YOUR HUMANITY. When I did prison nursing, everyone who worked there said the same thing, whether a nurse or correctional officer, the second you lose your humanity is the second you start on a downward spiral to burn out, ******* up, and losing your job. Since leaving correctional nursing, I appreciate every patient. Even if they're non-urgent and a real ****, at least they're not a serial killer. Let's cut the crap, be assertive, and be straight shooters. Let's be authentic, genuine, develop our own style as individuals, and be ourselves.

An ER nurse at the VA missed her first try on me. She knew I was a retired captain RN, and an ER nurse at a much larger ER than hers that saw heavy trauma; I think that made her nervous. I have a large, visible enough vein in each arm despite my few extra pounds and I think a fairly easy stick. I was very cool about her miss, smiling, almost jokingly, pointing out that I have a second arm, and unflinching in my confidence of her. She got me on the second try. The VA has always taken awesome care of me; I have zero complaints and only glowing things to say. When I start IVs I always assure the patient of my skill, decades of experience, and confidence. That makes most relax and they just give me their vein. I get most of my patients with one stick, and I assure them that is my goal every time, lab draw and IV in one stick. I sell myself as "one stick Sherri." The nervous ones I try harder to assure them of my skill, but you won't convince everyone. I was once horrible at IVs. I got good by researching IV start tips on the internet, then putting each technique into practice. I found blogs and websites written by paramedics were the most helpful. Whenever my accuracy got in a slump, or if I changed jobs that would require more IV starts than my previous job, I went back and reread the sites. Those sites gave me the best advice; you won't get them all. You are going to have misses. Just keep working on your craft and get better with each year of experience. I now LOVE starting IVs and would start them all if the other nurses would let me. I notice some procedure stealing on our unit. No bother, at least we're helping each other. It's a sign we love what we do. :-) One last thing--I got great on technique from tips from other nurses. I no longer soak the bed or my shoes in blood on IV starts; I know just where to hold tamponade now. So if you're good, share your knowledge!